Sharma Prachi, Cohen Joyce K, Lockhart Shawn R, Hurst Steven F, Drew Clifton P
Division of Pathology, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
Comp Med. 2011 Dec;61(6):532-7.
Mycotic aortic aneurysm is a local, irreversible dilatation of the aorta associated with destruction of the vessel wall by infection and is a grave clinical condition associated with high morbidity and mortality in humans. Rupture of aortic aneurysms can be spontaneous, idiopathic, or due to severe trauma, and the condition has been associated with bacterial and, rarely, fungal infections in humans and animals. Here, we describe a case of ruptured spontaneous aortic aneurysm associated with zygomycetic infection in a 21-y-old female sooty mangabey. The animal did not present with any significant clinical signs before being found dead. At necropsy, she was in good body condition, and the thoracic cavity had a large amount of clotted blood filling the left pleural space and surrounding the lung lobes. Near the aortic arch, the descending thoracic aorta was focally perforated (diameter, approximately 0.15 cm), and clotted blood adhered to the tunica adventitia. The aortic intima had multiple, firm, pale-yellow nodules (diameter, 0.25 to 0.5 cm). Histopathologically, these nodules consisted of severe multifocal pyogranulomatous inflammation intermixed with necrosis, fibrin, and broad, infrequently septate, thin-walled fungal hyphae. Immunohistochemistry revealed fungal hyphae characteristic of Mucormycetes (formerly Zygomycetes), and PCR analysis identified the organism as Basidiobolus spp. Dissemination of the fungus beyond the aorta was not noted. Spontaneous aortic aneurysms have been described in nonhuman primates, but this is the first reported case of a ruptured spontaneous aortic aneurysm associated with entomophthoromycetic infection in a sooty mangabey.
霉菌性主动脉瘤是主动脉局部的、不可逆的扩张,伴有感染导致的血管壁破坏,是一种严重的临床病症,在人类中具有高发病率和死亡率。主动脉瘤破裂可自发、特发性或由严重创伤引起,该病症在人类和动物中与细菌感染相关,真菌感染则较为罕见。在此,我们描述了一例21岁雌性黑冠猕猴发生的与接合菌感染相关的自发性主动脉瘤破裂病例。这只动物在被发现死亡前未表现出任何明显临床症状。尸检时,它身体状况良好,胸腔内有大量凝血,充满左胸腔并围绕肺叶。在主动脉弓附近,降主动脉有局部穿孔(直径约0.15厘米),凝血附着于外膜。主动脉内膜有多个坚实的淡黄色结节(直径0.25至0.5厘米)。组织病理学检查显示,这些结节由严重的多灶性脓性肉芽肿性炎症组成,伴有坏死、纤维蛋白以及粗大、少见分隔、薄壁的真菌菌丝。免疫组织化学显示为毛霉目(原接合菌纲)真菌菌丝的特征,聚合酶链反应分析鉴定该病原体为蛙粪霉属。未发现真菌超出主动脉的播散情况。自发性主动脉瘤在非人灵长类动物中已有报道,但这是首例报道的与虫霉目真菌感染相关的黑冠猕猴自发性主动脉瘤破裂病例。